Individual provider Active NPI

Adrienne Rochelle Rembert, D.D.S.

  • General Practice Dentistry
  • Fort Polk, LA
National Provider Identifier
1750627766
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401413777 Issued in VA
Practice address
7223 Mississippi Ave
US Army Dental Activity, Attn: Credentials
Fort Polk, LA 71459
Phone
(337) 531-4872
NPI assigned
Dec 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401413777 VA Primary

Addresses

Primary practice location

7223 Mississippi Ave
US Army Dental Activity, Attn: Credentials
Fort Polk, LA 71459

Mailing address

7223 Mississippi Ave, BLDG 1561
US Army Dental Activity, Attn: Credentials
Fort Polk, LA 71459
Phone (601) 259-2288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401413777VAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1750627766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7223 MISSISSIPPI AVE, BLDG 1561",
            "address_2": "US ARMY DENTAL ACTIVITY, ATTN: CREDENTIALS",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "71459",
            "telephone_number": "601-259-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7223 MISSISSIPPI AVE",
            "address_2": "US ARMY DENTAL ACTIVITY, ATTN: CREDENTIALS",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "71459",
            "telephone_number": "337-531-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REMBERT",
        "first_name": "ADRIENNE",
        "middle_name": "ROCHELLE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-19",
        "last_updated": "2023-04-04",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401413777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.